Functional and cognitive outcomes after COVID-19 delirium

Eur Geriatr Med. 2020 Oct;11(5):857-862. doi: 10.1007/s41999-020-00353-8. Epub 2020 Jul 14.

Abstract

Purpose: To ascertain delirium prevalence and outcomes in COVID-19.

Methods: We conducted a point-prevalence study in a cohort of COVID-19 inpatients at University College Hospital. Delirium was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function.

Results: In 71 patients (mean age 61, 75% men), 31 (42%) had delirium, of which only 12 (39%) had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium - 50 out of 166 points (95% CI - 83 to - 17, p = 0.01). Mean cognitive scores at follow-up were similar and delirium was not associated with mortality in this sample.

Conclusions: Our findings indicate that delirium is common, yet under-recognised. Delirium is associated with functional impairments in the medium term.

Keywords: Barthel Index; COVID-19; Delirium; Nottingham extended activities of daily living; Telephone interview for cognitive status.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • COVID-19
  • Cognition / physiology
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / mortality
  • Coronavirus Infections* / physiopathology
  • Cross-Sectional Studies
  • Delirium* / epidemiology
  • Delirium* / etiology
  • Delirium* / mortality
  • Delirium* / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / physiopathology
  • SARS-CoV-2
  • Severity of Illness Index